Proscar

Pros·car (prskär)

A trademark for the drug finasteride.

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finasteride Warning - Hazardous drug!

Propecia, Proscar

Pharmacologic class: Androgen inhibitor

Therapeutic class: Sex hormone, hair regrowth stimulant

Pregnancy risk category X

Action

Suppresses dihydrotestosterone levels by inhibiting the hepatic enzyme 5-alpha reductase, which converts testosterone to dihydrotestosterone in prostate, liver, and skin

Availability

Tablets: 1 mg (Propecia), 5 mg (Proscar)

⊘Indications and dosages

➣ Symptomatic benign prostatic hypertrophy (BPH)

Adults: 5 mg P.O. daily

➣ To reduce risk of progression of BPH symptoms

Adults: 5 mg P.O. daily (Proscar) given with doxazosin

➣ Male-pattern baldness

Adults: 1 mg P.O. daily

Off-label uses

• Acne in women
• Hirsutism

Contraindications

• Hypersensitivity to drug
• Females
• Children

Precautions

Use cautiously in:
• hepatic impairment, obstructive uropathy.

Administration

• Give with or without food.
• Know that female patients who are or may be pregnant shouldn't handle crushed or broken tablets. (Tablets are coated, so handling of intact tablets doesn't pose a problem).

Route	Onset	Peak	Duration
P.O. (BPH)	Unknown	8 hr	24 hr
P.O. (baldness)	3 mo	Unknown	Unknown

Adverse reactions

CNS: dizziness, headache, asthenia

EENT: lip swelling

GU: erectile dysfunction, decreased ejaculate volume, decreased libido, testicular pain, gynecomastia

Musculoskeletal: back pain

Skin: rash

Interactions

Drug-drug. Theophylline: increased theophylline clearance

Drug-diagnostic tests. Prostate-specific antigen (PSA): 50% decrease

Patient monitoring

• Carefully evaluate sustained PSA increases during therapy.
• Monitor fluid intake and output closely.

Patient teaching

• Tell patient he may take drug with or without food.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Inform patient that he may experience erectile dysfunction and decreased ejaculate. Advise him to discuss these issues with prescriber.
• Caution female caregiver or companion who is or may be pregnant not to handle crushed or broken tablets.
• Tell patient he may need at least 6 months of therapy for BPH treatment and at least 3 months to see improvement in male-pattern baldness.
• Inform patient with BPH that he'll undergo periodic digital rectal exams.
• Instruct patient not to donate blood for at least 1 month after last dose.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

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Proscar®

Finasteride, see there